America’s First Epidemic: The “Burning Fever” of Typhoid

Agonizing diseases wiped out the population of Jamestown, Virginia

Abigail_Adams.Benjamin Blyth / Public domain.

Abigail Smith Adams was a fascinating founder during America’s revolutionary and Federalist eras. Abigail was born in Massachusetts into a family with a long royal lineage dating back centuries in Europe. Although she did not receive a formal education she was well educated at home. She became married to founding father John Adams, who served in the Continental Congress and was elected the second President of the United States.

Abigail was known for voicing her outspoken opinions in public and in letters to John Adams while he served away from home in the Continental Congress at Philadelphia. Her letters to John show that she pressed him on the importance of using his power to give women equal legal status as men. She also advocated for the importance of educating women and the emancipation of slaves.

Abigail is remembered for an openness with her beliefs that would fit right in with some of today’s political decorum. For example, when talking about conversing with Alexander Hamilton, she remarked that she felt she had just “looked into the eyes of the devil himself.” Her mistrust of anti-Federalists like Thomas Jefferson earned her public monikers of “Mrs. President” and “Lady Adams”.

Although she was quick to point out her philosophical differences with Thomas Jefferson, after his daughter Maria’s death, she penned a letter to Jefferson and helped reestablish a relationship between the rival Presidents Adams and Jefferson. She also corresponded with another successor, Dolley Madison. But life in the colonial era was not as carefree as life in America today. Plagues and epidemics raged almost continuously and ultimately a common illness would consume Mrs. Adams.

Abigail was survived by John Adams, who lived another eight years after her death. Her son, John Quincy Adams, would become Secretary of State and was subsequently elected the sixth president of the United States. She died in 1818 at the advanced age of 73 from a fairly common disease at the time known as typhoid fever.

America’s First Epidemic

In 1607, long before Abigail Adams, the first European settlers arrived and built a fort by the James River in what would become Jamestown, Virginia. Many of the settlers brought diseases with them, which spread easily on the crowded ships. Once they arrived they struggled to produce enough food to survive. Even with subsequent reinforcements of more people, food, and supplies, the settlement struggled with leadership, moving into indigenous people’s territories, let alone maintaining their nutrition and health.

The early settlements of Jamestown and Plymouth, Massachusetts lost significant numbers to starvation, malnutrition, and disease. As a result of food shortages, the population was decimated by diseases, including typhoid, smallpox, dysentery, and tuberculosis. Faced with extinction, the colony officially disbanded in 1610 only to be immediately rejuvenated when new shipments of food and supplies arrived from England. But the epidemic of typhoid and the presence of other diseases continued for another fifteen years in Jamestown and would become a recurring plague during the coming centuries.

Malignant Bilious (Typhoid) Fever

The “burning fever” was America’s first epidemic and by 1625 it decimated 85% of the population on the James River in Virginia. Unbeknownst to the settlers at the time, the disease prevailed where there was poor sanitation, contaminated water, and overcrowding conditions. These scenarios were not uncommon on ocean voyages from Europe that took weeks, with people and animals crowded on ships.

When the colonial settlers arrived, often people continued to spend months on the boats while lodgings were being built in the new settlements. At the time the causes of the fevers were unknown and in some cases, the diseases were misdiagnosed using the benefit of todays knowledge. Typhoid, along with other febrile, or fever diseases, was thought to be caused by “miasmas”, or impure air, poisons, or even from spontaneous generation, where living organisms could somehow arise from non-living matter.

By the mid-1800s there were some physicians who believed that the fever could come from unsanitary conditions. Some physicians thought it might arise from “bodily excretions of the sick” or contaminated air or soil from “putrescent organic matter”. Historians like Abram Benenson calculated that typhoid alone killed more soldiers than battle wounds.

Researchers would eventually discover the salmonella bacteria that caused typhoid fever thrived in unsanitary conditions, especially where human waste mixed with food and water, or through close contact with infected victims.

Typhoid fever begins with a high fever, rose-spotted skin, body aches, loss of appetite, headache, cough, diarrhea, and restlessness. As the disease progresses, victims experience delirium, severe constipation, dehydration, and often, death. The typical duration of typhoid fever is 3 weeks. As with most of the European diseases, typhoid also decimated the indigenous populations as well.

Treatments For Febrile Diseases

Medical treatments and remedies of colonial times were meant to correct the imbalance of a patient’s four bodily humors: blood, phlegm, yellow bile, and black bile. Imbalances between the humors were seen as the root cause of illness. The prevailing theory in America and throughout Europe was that correcting the imbalance of a patient’s four bodily humors would cure him or her of disease. Febrile diseases, which were often all thought to be one disease, were treated with the same remedies.

As a result, treatments for typhoid fever included administration of bleeding, blistering, quinine, turpentine, brandy, and other concoctions, as we shall see. Eventually, some doctors arrived at the conclusion that prevention was more propitious than trying to cure the disease. Eventually, during the late1800s more attention was given to cleanliness, careful preparation of food, cleanliness of latrine areas and more care with drinking water.

Typhoid was not easily treated or eradicated and it continued to afflict Americans as the population grew during the next three centuries. In fact, during the American Civil War, the death rate for typhoid fever patients was 60%, owing in part to crowded military camps, ineffectual treatments, and crowded hospitals.


Typhus was often confused with typhoid during the 1700s, since they had similar symptoms. Although typhus may have been a problem in Europe and early colonial America it was not a big problem in American history by the 1800s and afterward. Although typhus thrived in Mexico and in other climates for some reason it was not able to establish a serious threat in America.

Unbeknownst to people at the time, human lice, which thrived especially well in linen clothing of summer, bedding, and hair, were the carriers of the bacterium Rickettsia. Many people didn’t bathe very frequently and didn’t change their clothes as often as they might have wanted. Likewise, typhus thrived in immigrant ships and overcrowded areas where lice could be passed on clothing or in hair.

Symptoms of typhus begin within two weeks after contact with infected body lice and they include fever and chills, headache, rapid breathing, rash, cough, nausea, vomiting, confusion, body and muscle aches. Since typhus was treated as a febrile disease, the same remedies applied for typhus as for typhoid.

The epidemic burning fever of typhoid was the norm in colonial America right up until the twentieth century. Nowadays, typhoid and typhus are prevented in most parts of the world where good sanitation and personal hygiene are practiced. Antibiotics are used to quickly stop the infections.

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Benenson, Abram S., “Immunization and Military Medicine”, Reviews of Infectious Diseases, Vol. 6 №1 (January — February 1984)

Human Lice: CDC

Author of Vermont’s Ebenezer Allen: Patriot, Commando and Emancipator by Arcadia/The History Press, University of Vermont EdD.

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